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Angiology Sanqiang Pan Department of Anatomy Medical College of Jinan University

Section four the veins I. Introduction • • • •

Definition: carry blood towards the heart Venous valve Superfical veins Deep veins

Venous valve

Varicosis

II. The pulmonary veins four in number → right superior and inferior pulmonary v. , left superior and inferior pulmonary v.

III. The systemic veins include three groups: a. superior vena cava and its tributaries, b. inferior vena cava and its tributaries, c. veins of heart

Brachiocephalic vein

Superior vena cava

Inferior vena cava Hepatic portal vein

(I) The superior vena cava and its tributaries 1. Superior vena cava 2. Brachiocephalic (innominate) veins a. internal jugular v.← facial v.(dangerous area of face) retromandibular v. b. subclavian v. ← external jugular v. • venous angle

Facial vein Retromandibular vein

Internal carotid vein

c. The veins of upper limb 1. Superficial v. • cephalic v.: arise from dorsal venous rete of hand • basilic v. • median cubital v. 2. Deep v. accompany the arteries which are similarly named

3 The azygos v. ←hemiazygos v. accessory hemizygos v.

(II) The inferior vena cava and its tributaries 1. Inferior vena cava 2. Common iliac v. a. internal iliac v. parietal tributaries visceral tributaries

b.external iliac v.

3.The veins of lower limb 1) The superficial v. • great saphenous v.: from dorsal venous arch of foot, has 5 tributaries • small saphenous v. 2) The deep v. : accompany the arteries which are similarly named

3 The tributaries of the inferior vena cava a. parietal tributaries b. visceral tributaries • testicular v. (ovarian v. in the female) ← the pampiniform plexus. Left drains into the left renal v. • renal v. • suprarenal v.:left drains into the left renal v. • hepatic v.

4. Hepatic portal vein a. Formation: splenic v. and superior mesenteric v. behind the neck of pancreas. b. Collection: blood from unpaired organs except liver c. The tributaries of the hepatic portal v. • superior mesenteric v. • inferior mesenteric v. • splenic v. • left and right gastric v. • paraumbilical v.

Splenic vein Portal vein

Superior mesenteric vein Inferior mesenteric vein

d. Anastomoses between the hepatic portal venous system and the vena cava 1. Hepatic portal v. →left gastric v. →esophageal venous plexus→esophageal v. →azygos v. →sup. vena cava 2. Hepatic portal v. →inf. mesenteric v. →sup. rectal v. →rectal venous plexus →inf. rectal and anal v. →internal iliac v. → common iliac v. →inf. vena cava 3. Hepatic portal v. →paraumbilical v. →periumbilical venous network → ① thoracoepigastric and sup. epigastric v. →sup. vena cava ② superficial and inf. epigastric v. →inf. vena cava

4.Hepatic portal v. →small tributaries of the superior and inferior mesenteric v. → small tributaries of the posterior intercostals v.,inferior phrenic v., renal v.and testicular v. →sup. and inf. vena cavae

5. Hepatic portal v. →small tributaries of the superior and inferior mesenteric v. → vertebral venous plexus→small tributaries of the posterior intercostals v., lumbar v. →sup. and inf. vena cavae

E. Clinical anatomy Portal hypertension • Obstructed by cirrhosis of liver, tumor of liver • Results in esophageal hemorrhage, retal hemorrage and “caput medusae” of the umbilicus

Varicose veins

Caput medusae

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